Individual provider Active NPI

John Hamner Payne III, M.D.

  • Diagnostic Radiology Physician
  • Montgomery, AL
National Provider Identifier
1366436610
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
00003874 Issued in AL
Practice address
2055 Normandie Dr
Suite 108
Montgomery, AL 36111-2732
Phone
(334) 288-4624
Fax
(334) 280-3628
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 00003874 AL Primary
Diagnostic Radiology Physician 2085R0202X ME90622 FL

Addresses

Primary practice location

2055 Normandie Dr
Suite 108
Montgomery, AL 36111-2732

Mailing address

2055 Normandie Dr
Suite 108
Montgomery, AL 36111-2732
Phone (334) 288-4624

Other identifiers 2

IdentifierTypeStateIssuer
108112MedicaidAL
108568MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00003874ALMDDiagnostic Radiology Physician
3874ALMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1366436610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 NORMANDIE DR",
            "address_2": "SUITE 108",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112732",
            "telephone_number": "334-288-4624",
            "fax_number": "334-280-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 NORMANDIE DR",
            "address_2": "SUITE 108",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112732",
            "telephone_number": "334-288-4624",
            "fax_number": "334-280-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "JOHN",
        "middle_name": "HAMNER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "00003874",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME90622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108112",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108568",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.